Note 3.-An person in attendance on a case of syphilis or gonococcus infection who fails to report the case promptly to the local health officer is guilty of a misdemeanor, punishable by a fine of not less than $25 nor more than $500, or by imprisonment for a term of not more than 90 days, or by both such fine and imprisonment. (See Public Health Act, sections 13 (rule 2), 16, and 21.) Note 4.-Physicians attending cases of syphilis and gonococcus infection are expected to furnish to the health officer at the times of reporting the case, any available useful data regarding the sources of infection, in order to assist in the control of these diseases. RULE 2. Diagnosis.-The local health officer may require the submission of specimens from cases of syphilis or gonococcus infection, or cases suspected of being cases of syphilis or gonococcus infection, for the purpose of examination at a State or municipal laboratory. It shall be the duty of every physician attending a case of syphilis, or gonococcus infection, or a case suspected of being one of syphilis or gonococcus infection, to secure specimens for examination when required to do so by the local health officer. Vote 1.-Examinations of blood for syphilis by the Wassermann test, and microscopic examinations of smears of pus for gonococci are made without charge by the bureau of communicable diseases at Berkeley If the specimens are properly taken and mailed in the containers furnished by the bureau of communicable diseases. It is expected that the larger cities will provide adequate laboratory facilities. (See directions for sending material to the laboratory.) RULE 3. Instructions to the patient.-It shall be the duty of the physician in attendance on a person having syphilis or gonococcus infection, or suspected of having syphilis or gonococcus infection, to instruct him in precautionary measures for preventing the spread of the disease, the seriousness of the disease, and the necessity for prolonged treatment, and the physician shall, in addition, furnish approved literature on these subjects. Note 1.-Approved literature for distribution to patients may be secured from the bureau of venereal diseases of the State board of health, 525 Market Street, San Francisco. Note 2.-The following instructions are required as a minimum by rule 2: (a) To patients having syphilis: 1. Syphilis or pox is a contagious disease. It can usually be cured, but it requires two or more years of treatment. 2. You must not marry until a reputable physician has pronounced you cured. 3. Avoid all sexual relations. 4. Always sleep alone. 5. Do not kiss anyone. 6. Never permit anyone to use anything which has been in your mouth, such as toothpicks, toothbrushes, pipes, cigars, pencils, spoons, forks, cups, etc., or anything else that you have contaminated. 7. Il you have to see a dentist, tell him about your disease before he examines your teeth. 8. Avoid patent medicines, so-called "medica. institutes” and advertising "specialists." 9. Consult a reputable physician, or, in case of financial inability, the city or county physician, or a reputable dispensary such as is found in connection with most large public hospitals, and follow direcLions absolutely. (b) To patients having gonorrhea: 1. Gonorrhea, "clap," or gleet, is a serious contagious disease. If properly treated it can usually be cared. 2. You must not marry until a reputable physician has pronounced you cured. 3. Avoid all sexual relations. 4. Always sleep alone, and be sure that no one uses your toilet articles, particularly your towels and wash e.oths. 3. Always wash your hands thoroughly after handling the diseased parts The discharge, it carried to your eyes, may cause blindness. 6. Avoid patent medicines, so-called "medical institutes” and advertising "specialists." 7. Consult a reputable physician, or, if financially unable to do so, the city or county physician, or a mputable dispensary such as is ound in connection with most large public hospitals, and ol.ow directons absolutely. Note-I'any person has knowledge that a person infected with syphilis or gonococcus infection is ailing to observe adequate precautions to prevent spreading infection, he shal. report the facts at once to the local beaith officer RULE 4. Health officers designated inspectors.-All city, county and other local health officers are, for the purpose of the control and suppression of venereal diseases, hereby designated and appointed inspectors, without salary, of the State board of health of California, under the provisions of section 2979 of the Political Code. Note 1.-The following paragraph is quoted from section 2979 of the Political Code: "It (the State board of health) shall have general power of inspection, examination, quarantine and disinfection of persons, places and things, within the State, and for the purpose of conducting the may appoint inspectors, who, under the direction of the board, shall be vested with like powers: Providek, That this act shall in nowise conflict with the national quarantine laws." RULE 5. Investigation and control of cases.-All city, county and other local health officers are hereby directed to use every available means to ascertain the existence of, and immediately to investigate, all reported or suspected cases of syphilis in the infectious stages and gonococcus infection within their several territorial jurisdictions, and to ascertain the sources of such infections. In such investigations said health officers are hereby vested with full powers of inspection, examination, isolation and disinfection of all persons, places and things, and as such inspectors said local health officers are hereby directed: (a) To make examinations of persons reasonably suspected of having syphilis in the infectious stages or gonococcus infection. (Owing to the prevalence of such die eases among prostitutes, all such persons may be considered within the above class (b) To isolate such persons whenever, in the opinion of said local health officer, the State board of health or its secretary, isolation is necessary to protect the public health. In establishing isolation the health officer shall define the limits of the area in which the person reasonably suspected or known to have syphilis or gonococcus infections and his immediate attendant, are to be isolated, and no persons, other than the attending physicians, shall enter or leave the area of isolation without the permission of the health officer. (c) In making examinations and inspections of women for the purpose of ascertaining the existence of syphilis or gonococcus infection, to appoint women physicians for said purposes where the services of a woman physician are requested or demanded by the person examined. (d) In cases of quarantine or isolation, not to terminate said quarantine or isolation until the cases have become noninfectious or until permission has been given by the State board of health or its secretary. Cases of gonococcus infection are to be regarded as infectious until at least two successive smears taken not less than 48 hours apart fail to show gonococci. Cases of syphilis shall be regarded as infectious until all lesions of the skin or mucous membranes are completely healed. (e) Inasmuch as prostitution is the most prolific source of syphilis and gonococcus infection, all health officers are directed to use every proper means of repressing the same, and not to issue certificates of freedom from venereal diseases, as such certifi cates may be used for purposes of solicitation. (ƒ) To keep all records pertaining to said inspections and examinations in files not open to public inspection, and to make every reasonable effort to keep secret the identity of those affected by venereal disease control measures as far as may be consistent with the protection of the public health. RULE 6. Report of unusual prevalence.-When the local health officer, through investigation, becomes aware of unusual prevalence of syphilis or gonococcus infection, cr of unusual local conditions favoring the spread of these diseases, he shall report the facts at once to the bureau of venereal diseases, 525 Market Street, San Francisco. Venereal Diseases-Standards for Dispensaries and Hospitals. (Reg. Bd. of H., Oct. 6, 1917.) DISPENSARIES TREATING SYPHILIS. 1. Special department.-Syphilis shall be treated in a special department or the department of dermatology. 2. Number of sessions.-The dispensaries shall be open at least three times a week, day or evening. 3. Staff-The staff shall be adequate in number and training. 4. Equipment.-Enough well-arranged rooms, laboratory facilities and equipment, with instruments and apparatus, shall be provided. 5. Beds. Every dispensary shall have at its disposal beds for isolation or treatment. 6. Records. Adequate records of all cases shall be kept. 7. Social service required.—A social service department shall be maintained and adequate measures adopted to secure a regular attendance of patients. 8. Information to patients. Clinicians shall devote the amount of time necessary for intelligently informing new patients of the seriousness of their disease, the necessity for prolonged treatment, and the precautions necessary to prevent the spread of infection to others, and the clinics shall, in addition, furnish approved literature on these subjects. (This literature can be secured from the bureau of venereal diseases.) 9. Microscopic examinations.-Microscopic examinations of suspected initial lesions shall be made. 10. Wassermann tests.-Wassermann tests shall be performed in the dispensary laboratory or other approved laboratory. 11. Administration of salvarsan or equivalents.—Salvarsan or accepted equivalents shall be administered to all cases where there are no contraindications. (Salvarsan or approved substitutes may be obtained without cost from the bureau of venereal disCases, 525 Market Street, San Francisco, for the treatment of infectious cases of syphilis in approved dispensaries.) 12. Procedure covering the discharge of patients.—Suitable tests and observations shall be made of all patients for a period of not less than two years after the conclusion of adequate treatment. (See pamphlet "Modern Treatment of Syphilis," obtainable from the bureau of venereal diseases.) 13. Transfer of patients.—If it becomes necessary for any reason to discharge a patient still uncured, the patient shall be referred to an approved dispensary or a reputable physician. 14. Annual report.-An annual report of work done in the dispensary shall be made. It is suggested that this include the number of new and old patients and number of visits made, the number of patients continued under observation and treatment from one year into the next, the number of doses of salvarsan or equivalent administered (with a separate list of free doses), and the number of patients discharged as cured. DISPENSARIES TREATING GONORRHEA. 1. Number of sessions.-Dispensaries shall be open at least three times a week, day or evening. 2. Staff. The staff shall be adequate in number and training. 3. Equipment.-Enough well-arranged rooms, laboratory facilities and equipment, with instruments and apparatus, shall be provided. 4. Beds. Every dispensary shall have at its disposal beds for isolation or treatment. 5. Records.-Adequate records of all cases shall be kept. 6. Social service required.-A social service department shall be maintained and adequate measures adopted to secure a regular attendance of patients. 7. Information to patients.-Clinicians shall devote the amount of time necessary for intelligently informing new patients of the seriousness of their disease, the necessity of treatment until cured, and the precautions necessary to prevent the spread of infection to others, and the clinic shall, in addition, furnish approved literature on these subjects. (This literature can be secured from the bureau of venereal diseases.) 8. Microscopic examination.-Systematic microscopic examination of discharges shall be made in departments treating patients affected with gonorrhea. 9. Facilities for asepsis and antisepsis.—All departments treating patients affected with gonorrhea shall be equipped with adequate facilities for asepsis and antisepsis. 10. Urethroscopic and cystoscopic examination.-Facilities for urethroscopic and cystoscopic examination shall be provided and regularly employed by the attending clinicians. 11. Procedure governing discharge of patients.-Patients shall be discharged as cured only after repeated negative clinical and microscopic examinations. 12. Transfer of patients.—If it becomes necessary for any reason to discharge a patient still uncured, the patient shall be referred to an approved clinic or reputable physician. 13. Annual report.-An annual report of work done in the dispensary shall be made It is suggested that this include the number of new and old patients, the number of visits made, the number of patients continued under observation and treatment from one year into the next, and the number of patients discharged as cured. HOSPITALS TREATING SYPHILIS AND GONORRHEA. 1. No discrimination against venereal diseases.-Patients having venereal diseases must be accepted under the same conditions as other patients. 2. General standard of hospital.—The hospital shall be properly equipped and well conducted. 3. Staff and equipment.—There shall be adequate staff and equipment for the diagnosis, treatment and keeping of records in cases of syphilis or gonococcus infection in general accord with the standards indicated for approved dispensaries. 4. Follow-up.-Social service and follow-up work shall be carried on as indicated for approved dispensaries, either by the hospital or by an approved dispensary to which patients are transferred. Communicable Diseases-Pesthouses or Hospitals-Prohibition Against Maintcnance in Cities and Towns Removed. (Ch. 44, Act Apr. 5, 1917.) SECTION 1. Section 373 of the Penal Code is hereby repealed. SEC. 373. Every person who establishes or keeps, or causes to be established or kept, within the limits of any city, town, or village, any pesthouse, hospital, or place for persons affected with contagious or infectious diseases, is guilty of a misdemeanor. Occupational Diseases-Act Requiring Reporting of, Repealed. (Ch. 227, Act May 11, 1917.) SECTION 1. An act entitled "An act to provide for the reporting of occupational diseases," approved April 21, 1911, is hereby repealed. Rodents, Insects, and Other Vermin-Extermination. (Ch. 531, Act May 18, 1917.) SECTION 1. Section 2 of an act' entitled "An act to prevent the introduction, and provide for the investigation and suppression of contagious or infectious diseases, and appropriating money to be used for such purpose," approved June 7, 1913, is hereby amended to read as follows: Pub. Health Repts. Reprint 264, p. 64. SEC. 2. Whenever any land, place, building, structure, wharf, pier, dock, vessel or water craft, or other property is infested with rodents, insects, or other vermin which are liable to convey or spread contagious or infectious disease from an existing focus declared by the State board of health, it shall be the duty of said board to at once notify the person, firm, copartnership, corporation, city, city and county, county, or district, owning said land, place, building, structure, wharf, pier, dock, vessel, or water craft, or other property of the existence of said rodents, insects, or other vermin, and said notice shall direct said owner to proceed immediately to exterminate and destroy said rodents, insects, or other vermin, and to continue in good faith such measures as may be necessary to prevent their return. Service of such notice upon a trustee, executor or administrator of the estate of the recorded owner of said property shall be deemed sufficient notice to the owner as provided herein and in the event the owner is absent from the State or can not with due diligence be found, said notice shall be mailed to such owner addressed to his address given on the last completed assessment roll of the county, or city and county in which said property is situate, or if no address be so given, then to his last known address and a copy of said notice shall be posted in a conspicuous place upon said property for a period of 10 days. In the event that said owner fails, refuses or neglects to proceed and continue as above provided, within 10 days from date of receipt of said notice, the State board of health may proceed to destroy said rodents, insects or other vermin, and take other appropriate measures to prevent their return, and the cost thereof shall be repaid to the State board of health by the owner of said land, place, building, structure, wharf, pier, dock, vessel, water craft or other property: Provided, however, That said owner shall not be liable for expenditures in any one year, in excess of 10 per cent of the assessed valuation of such property, and the appropriation provided in section 1 of this act shall be reimbursed by the amount so paid, and may be again expended in a similar manner. SEC. 2. Section 3 of an act entitled "An act to prevent the introduction, and provide for the investigation and suppression of contagious or infectious diseases, and appropriating money to be used for such purpose," approved June 7, 1913, is hereby amended to read as follows: SEC. 3. Any and all sums so expended by said State board of health shall be a lien upon the property on which such rodents, insects or other vermin shall have been destroyed, or other appropriate measures taken, The State board of health shall cause to be filed in the office of the county recorder of the county wherein said property is situated a notice setting forth the amount so expended by the State board of health and claiming a lien upon such property for the amount of such expenditures. Such claim of lien must be filed within six months after the first item of expenditure. An action to foreclose such lien shall be commenced within six months after the filing and recording of said notice of lien, which action shall be brought by the State board of health through its attorney and for its benefit: Provided, however, That the lien provisions of this act shall not apply to the property of any county, city and county, municipality, district, or other public corporation, but it shall be the duty of the governing body of such county, city and county, municipality, district or other public corporation to repay the State board of health the amount expended by it upon such property under the provision of this act upon presentation by said State board of health of a verified claim or bill showing the amount of such expenditures. When the property is sold, enough of the proceeds to satisfy such lien and the costs of foreclosure shall be paid into the State treasury for the benefit of the fund herein created and the overplus, if any there be, shall be paid to the owner of the property if known, and if not known, shall be paid into the court for the use of such owner when ascertained. When it appears from the complaint in such action that the property on which such lien is to be foreclosed is likely to be removed from the jurisdiction of the court, the |